From Diagnosis to Decision: How Guerdy Abraira Used Genomic Testing to Navigate Breast Cancer

For Guerdy Abraira — renowned event designer, TV personality, and breast cancer survivor — the spring of 2023 marked a transition from a meticulously scheduled professional life to the unpredictable reality of a cancer diagnosis.

At the CURE Educated Patient Breast Cancer Summit, held in tandem with the 43rd Annual Miami Breast Cancer Conference, Abraira detailed the diagnostic process, the role of genomic testing in her treatment plan, and her subsequent shift in perspective regarding health and recovery.

From Screening to Receiving a Diagnosis

Abraira received her diagnosis in March 2023, with initial findings suggesting ductal carcinoma in situ (DCIS), referred to as stage 0. She underwent the recommended intervention of a lumpectomy; however, following a biopsy and MRI, the diagnosis was revised to stage 1B invasive breast cancer. This escalation necessitated a more complex multimodal treatment strategy, involving surgery, radiation, and chemotherapy.

“It was definitely a roller coaster,” she said on a panel discussion at the summit.

The Role of Diagnostic Testing for Recurrence Score

A critical component of Abraira’s clinical journey was the use of the Oncotype DX test, a genomic assay that analyzes the expression of 21 genes within breast cancer tissue. This test provides a recurrence score, which helps oncologists and patients understand the likelihood of the cancer returning and, specifically, whether the addition of chemotherapy to hormone therapy will provide a significant clinical benefit.

Abraira’s score was 29. On the test's scale of 1 to 100, this result indicated a high enough risk of recurrence that chemotherapy was recommended to reduce the chances of distant metastasis.

“That changed the complete trajectory of my treatment because, beforehand, it was supposed to be just a lumpectomy and potentially radiation, and with the Oncotype DX test, chemotherapy was the true key element that changed everything to help me reduce my risk for recurrence,” she explained. “I was able to feel like I had control over a decision to foresee what would be most beneficial for me to help reduce the risk of recurrence.”

In addition to the Oncotype DX test, Abraira underwent hereditary genetic testing to determine if her cancer was linked to specific inherited mutations, such as BRCA1 or BRCA2. The results were negative, providing important health information for her siblings and children.

Joining Abraira on the panel, Dr. Kevin Kalinsky, professor and director in the Division of Medical Oncology of the Department of Hematology and Medical Oncology at Emory University School of Medicine, added that genomic testing enables tailored treatment for patients.

“We are increasingly wanting to tailor treatment based upon the biology. I think we've all tried to move away from a one-size-fits-all approach,” he explained. “When we consider these tests, we also take into account the patient’s age, tumor size, grade, and clinical risk. That information helps guide individualized treatment decisions.”

Treatment and Long-Term Management

Following her surgical procedure, Abraira completed her chemotherapy and radiation regimens. She is currently nearly one year cancer-free and maintains a rigorous long-term management plan that includes:

• Endocrine therapy: A five-year course of anastrozole, an aromatase inhibitor used to treat estrogen receptor-positive breast cancer by blocking hormone production.
• Monitoring: Diagnostic imaging, including mammograms, ultrasounds, and MRIs, every six months.
• Bone health: Regular bone density scans to monitor potential side effects of endocrine therapy, supplemented by weight-bearing exercise.
• Physical therapy: A focus on lymphatic drainage and daily walking to manage physical side effects such as neuropathy and fatigue.

Advocacy and Cultural Impact

Abraira also highlighted the importance of the patient-physician relationship. She noted that while patients are often in a state of shock following a diagnosis, proactive communication with one’s care team regarding testing options — like genomic assays — can significantly alter the trajectory of a patient's care and mental well-being.

“I never wanted to hear the ‘C’ word altogether. But, you know, I was able to try to wrap my head around the word cancer,” she said.

By sharing the technical and emotional aspects of her experience, Abraira remains a vocal advocate for those who have utilized genomic testing to navigate their breast cancer treatment.

“Aim small, miss small. You have to honestly take a step back, not overwhelm yourself, and take it one second, one minute, one day at a time. That's the best you can do for yourself, for your mental health, for your physical health” she added. “You have to see that little light at the end of the tunnel…so you just have to pace yourself”.

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